Every 3 weeks, Dr. Daniel Kraus hops on a plane at 7 am and flies 531 km to see patients with chronic mental illness in the Northern Quebec town of Val d'Or. Every 6 weeks he continues on from Val d'Or to other remote communities, checking in on his schizophrenic patients along the way. At the end of the day, he flies home to Montreal.
This peripatetic life — after 22 years, he has the routine down pat — lets the McGill psychiatrist be part of many communities. “Each of these towns has its unique identity, its own history, its own idiosyncrasies. And it's just beautiful country to roll through.”
An avid hiker and cyclist, Kraus rarely gets a chance to experience the backwoods when he is up North. As one of the few psychiatrists seeing outpatients in the mining towns of Val d'Or and Timmins, Ont., he has almost no free time. Another of his regular stops is Cochrane, an Ontario town with 4500 residents. Since 1992, Kraus has been its sole psychiatrist.
Despite the shortage of help, Kraus says patients who develop a mental illness may be better off in places like Val d'Or than in Montreal. In the North, he says, they become more integrated into the life of their small communities and have a greater sense of belonging.
Flying in and flying out every few weeks gives Kraus a break in his routine and satisfies his desire to see how patients fare over the long term. “I've known some of these patients for 15 to 20 years. The life stories of people who work in the mines or who go into the forest to cut their own wood are very different from the stories I hear in Montreal.”
Despite his commitment to outreach psychiatry in the North, Kraus is a city boy at heart. He grew up in Westchester, NY, but has lived in the heart of Montreal most of his adult life. A pianist, he was awarded a master's degree in music performance the day he graduated from medical school.
Kraus first flew north in the cockpit of a turbo-prop owned by Dr. Maurice Dongier, the Montreal psychiatrist who pioneered the provision of psychiatry services in remote communities. Because Kraus has a pilot's licence, he often flew the plane himself. Now that commercial airlines fly the route, he contents himself with driving the backroads between towns and meeting up with the occasional moose, bear or flooded highway along the way. “I can go the 72 km between Duparquet [Quebec] and Matheson [Ontario] and not see another car,” he says.
The other perk is the people. “It's really about forming relationships,” he says. “Psychiatry is a very transportable skill. I don't have to bring equipment along — I just bring myself.” — Susan Pinker, Montreal